Table 4.
Examples of metabolomic studies associated with gestational diabetes mellitus.
| Sample specimen | Participants (n) | Outcomes | Analytical platforms | Metabolites | Statistical analysis | References |
|---|---|---|---|---|---|---|
| Plasma | 31 (18 GDM) | GDM vs controls | LC-ESI-QqQ-MS/MS | L-asparagine (Asn), L-valine (Val), and L-ornithine (Orn) were decreased and L-citrulline (Cit) was elevated in GDM cases compared to controls | P<0.05 | [178] |
| Serum (3rd trimester) | 22 (12 GDM) | GDM vs controls | UPLC-QTOF-MS | 9 metabolites were observed with AUC>0.7 to diagnose GDM from healthy controls which are 1- methyladenosine, glucosamine, L-tyrosine, phosphorylcholine, L-lactic acid, 3-methylthiopropionic acid, lysoPC(16:1), L-2- hydroxyglutaric acid, and trans-3-octenedioic acid | P<0.05 | [64] |
| Serum (16 weeks of gestation) | 358 (178 GDM) | GDM vs controls | GC-MS | 17 metabolites: linoleic acid, oleic acid, myristic acid, d-galactose, d-sorbitol, o-phosphoco- lamine, l-alanine, l-valine, 5-hydroxy-l-tryptophan, l-phenylalanine-phenyl, l-serine, sarcosine, l-pyroglutamic acid, and l-mimosine, l-lactic acid, glycolic acid, fumaric acid, and urea expressed differentiation between GDM cases and controls | Regression analysis, these metabolites together with GDM risk factors (maternal age, family history, prepregnancy BMI, ferritin, CRP, hep- cidin, and total vitamin D) gave rise to an AUC of 0.87 | [179] |
| Plasma (24-27 weeks of gestation, at OGTT test) | 24 (9 GDM) | GDM vs controls at OGTT test | FIA-MS/MS and LC-MS for amino acids, acylcarnitines, sphingomyelins, phosphatidylcholines, hexose (glucose) and biogenic amines; Fatty acids analysis by GC-MS | reference model complemented by a clinical model(BMI, AUC of glucose and insulin) gave rise to 8 metabolites C18:0 carnitine, PC aa C34:4, PC aa C36:4, PC aa C38:5, PC ae C36:4, PC ae C36:5, LPC C20:4 and arachidonic acid which showed differences between GDM cases and controls | P<0.01, reference model: 96.4% AUC and clinical model: 99.3% AUC | [63] |
| Serum (fasting) | 192 (96 GDM) | GDM vs controls | LC-MS | anthranilic acid, alanine, glutamate, allantoin and serine were increased and creatinine decreased in GDM cases compared to controls | P<0.05 | [180] |
| Serum (20 weeks) | 48 (22 GDM) | GDM vs controls | GC-MS | Itaconic acid with P=0.0003 was significantly increased in women who developed GDM later on during pregnancy compared to controls, cis-aconitate levels were also higher in GDM cases and verging on statistical difference (P=0.013) | P<0.01 | [74] |
| Urine and plasma (Fasting) | 40 (20 GDM) | GDM vs controls | LC-QTOF-MS(plasma), GC-Q/MS(plasma), CE-TOF/MS(urine) | After ROC analysis metabolites with a ROC area >0.94 and has shown a discriminative ability by 25 lysoglycerophospholipids, arachidonic 20:4) and docosahexaenoic (22:6) acid methyl esters, and taurine-conjugated bile acids. Lipoxin was another lipid which showed a high discriminative power and associated with diabetic outcome | ROC area>0.94 | [65] |
| Urine (8-20 gest. week, week 28+/-2, 10-16 weeks after pregnancy) | 609 (13% GDM) | GDM vs controls | NMR | Significant increase of citrate levels associated with GDM severity | P<0.05, R2>95% | [181] |